A tracheotomy is a common surgical procedure in which a doctor creates an incision into the trachea, forming an opening known as a tracheostomy. The doctor utilizes the tracheostomy for accessing the trachea and placing a tube into the patient's trachea (or “windpipe”) to assist with breathing. This artificial airway, commonly referred to as a tracheostomy tube, allows for air to bypass a portion of the windpipe, which may be damaged or obstructed, and ensure proper breathing through the lungs. The tracheostomy tubes are useful for individuals who are currently or have recently been assisted by a ventilator, who have upper airway obstructions, and those who have chronic physical conditions that make normal breathing too difficult to achieve without assistance.
In standard practice, the tracheostomy tube consists of an outer tube inserted into the trachea, an inner tube (or inner cannula) that fits snugly within the outer tube and is removable for replacement purposes, a flange that fits snugly against the patient's neck, and a terminating portion that protrudes from the tracheostomy. The flange is usually adapted with ties that connect around a patient's neck or onto an associated collar for holding the tracheostomy tube in fixed position. The terminating portion of the tracheostomy tube is adapted for connecting with secondary medical equipment such as a ventilator. Needless to say, the tracheostomy tube fitting is complicated and uncomfortable.
A problem arises for patients with tracheostomy tubes, particularly those with associated ventilators, in that the weight of the ventilator connectors pull on the tube. A patient connected to a ventilator also risks injury or damage to the trachea when the patient moves in one direction or the other. The downward force on the tracheostomy tube and the side to side forces caused by the patient moving around may easily irritate the trachea, leading to bleeding or even infection. At worst, these outside forces on the tracheostomy tube may dislodge the tube from its intended position, requiring immediate medical attention.
The medical community and the patients alike would benefit from an apparatus to make the tracheostomy tube more comfortable, more reliable, and less vulnerable to dislodging and irritation. Attempts in this field are summarized below.
U.S. Pat. No. 7,472,706 (Weiss) describes a tracheostomy tube support that includes a tubular cushion having a through hole. The Weiss patent describes that the tubular cushion is preferably made of “soft, skinned, closed-cell polymeric foam such as ‘Microcell.’” The closed-cell polymeric foam used to form the tubular cushion has the property of low moisture absorption. A flexible tie for securing the cushion against the neck passes through the through hole. The flexible tie may be tied around the neck or may use hook and loop fasteners to secure the flexible tie to a tracheostomy collar.
U.S. Pat. No. 5,163,914 (Abel) discloses a respirator hose support pad for tracheostomy patients. The support pad includes a soft and somewhat resilient interior covered by a flexible outer material. The support pad is placed across the chest of a tracheostomy patient and near the tracheostomy tube. A belt, which is attached to the support pad, loosely holds the respirator hose so that the respirator hose can move in response to patient movements. This ease of movement helps to prevent unwanted tension and thus patient discomfort. The support pad serves to slightly elevate the respirator hose. A downward angle in the respirator hose is formed in the portion of the respirator hose opposite the tracheostomy tube. This set-up serves to prevent fluid condensation from entering the tracheostomy tube and the patent's lungs. Instead, fluid condensation drains into a collection vial.
U.S. Pat. No. 5,749,360 (Lacey) describes a tracheostomy mask for delivering gaseous therapeutics to a patient fitted with a tracheostomy tube. The mask includes a coupling ring for connecting the mask to a supply tube. A tubular structure within the mask connects the supply tube to the tracheostomy tube. The stabilizer (i.e., the opening of the tubular structure that receives the tracheostomy tube) has an opening larger than the outside diameter of the tracheostomy tube, which allows the mask to move without placing uncomfortable strain on the tracheostomy tube. Moreover, the mask will pull away from the tracheostomy tube without placing undue stress on the tracheostomy tube after the application of a significant force. The mask includes a number of weep holes that provide drainage for fluids (e.g., mucous, phlegm, and excess condensation). The weep holes are positioned so that gravity acts to drain such fluids and thereby prevent the obstruction of the airway.
The above noted patent publications fail to solve certain notable problems in the art of tracheostomy tube support. Namely, the tube support needs to be absorptive, stabilizing, adaptable for variously sized tubes and hoses, and re-usable if desired. Each of these features is discussed in detail below.